\n EDITOR\u2019S NOTE:\u00a0 This article was updated on Oct. 31, 2025, to include social media comments from Mehmet Oz, administrator of the Centers for Medicare & Medicaid Services, that he posted after publication.\n<\/p>\n
\n The Trump administration has ordered states to investigate certain individuals enrolled in Medicaid to determine whether they are ineligible because of their immigration status, with five states reporting they\u2019ve together received more than 170,000 names collectively \u2014 an \u201cunprecedented\u201d step by the federal government that ensnares the state-federal health program in the president\u2019s immigration crackdown.\n <\/p>\n
\n Advocates say the push burdens states with duplicative verification checks and could lead people to lose coverage just for missing paperwork deadlines. But the administrator of the Centers for Medicare & Medicaid Services, Mehmet Oz, said in a post on the social platform X on Oct. 31 that more than $1 billion \u201cof federal taxpayer dollars were being spent on funding Medicaid for illegal immigrants\u201d in five states and Washington, D.C.\n <\/p>\n
\n Medicaid\u2019s overall spending topped $900 billion in fiscal year 2024.\n <\/p>\n
\n It wasn\u2019t clear from Oz\u2019s statement or an accompanying video over what period the spending happened, and CMS spokespeople did not immediately respond to questions, either for an earlier version of this article or after Oz\u2019s statement was posted.\n <\/p>\n
\n Only U.S. citizens and some lawfully present immigrants are eligible for Medicaid, which covers low-income and disabled people, and the closely related Children\u2019s Health Insurance Program. Those without legal status are ineligible for federally funded health coverage, including Medicaid, Medicare, and plans through the Affordable Care Act marketplaces.\n <\/p>\n
\n At least one state said it disagreed with Oz\u2019s comments.\n <\/p>\n
\n \u201cOur payments for coverage of undocumented individuals are in accordance with state and federal laws,\u201d said Marc Williams, a spokesperson for Colorado\u2019s Department of Health Care Policy & Financing, which administers the state\u2019s Medicaid program. \u201cThe $1.5 million number referenced by federal leaders today is based on an incorrect preliminary finding, and has been refuted with supporting data by our Department experts.\u201d\n <\/p>\n
\n He added: \u201cIt is disappointing that the administration is announcing this number as final when it is clearly overstated and the conversations are very much in the education and discussion phase.\u201d\n <\/p>\n
\n In August, CMS began sending states the names of people enrolled in Medicaid that the agency suspected might not be eligible, demanding state Medicaid agencies check their immigration status.\n <\/p>\n
\n KFF Health News in October reached out to Medicaid agencies in 10 states. Five provided the approximate number of names they had received from the Trump administration, with expectations of more to come: Colorado had been given about 45,000 names, Ohio 61,000, Pennsylvania 34,000, Texas 28,000, and Utah 8,000. More than 70 million people are enrolled in Medicaid.\n <\/p>\n
\n Most of those states declined to comment further. Medicaid agencies in California, Florida, Georgia, New York, and South Carolina refused to say how many names they were ordered to review or did not respond.\n <\/p>\n
\n Oz said in his X post that California had misspent $1.3 billion on care for people not eligible for Medicaid, while Illinois spent $30 million, Oregon $5.4 million, Washington state $2.4 million, Washington, D.C., $2.1 million, and Colorado $1.5 million.\n <\/p>\n
\n \u201cWe notified the states, and many have begun refunding the money,\u201d he said. \u201cBut what if we had never asked?\u201d\n <\/p>\n
\n Washington, D.C.\u2019s Medicaid director, Melisa Byrd, said CMS had identified administrative expenses for the district program that covers people regardless of immigration status that should not have been billed to the federal government and her agency has already fixed some of those areas. \u201cWe run a big program that is very complex and when mistakes or errors happen, we fix them,\u201d she said.\n <\/p>\n
\n The program plans to pay $654,014 back to CMS by mid-November.\n <\/p>\n
\n All five states, plus Washington, D.C., are led by Democrats, and President Donald Trump didn\u2019t win any of them in the 2024 election.\n <\/p>\n
\n In recent days, Deputy Health and Human Services Secretary Jim O\u2019Neill began posting pictures<\/a> on X of people he said are convicted criminals living in the U.S. without authorization who had received Medicaid benefits.\n <\/p>\n \n O\u2019Neill could not be reached for comment.\n <\/p>\n \n \u201cWe are very concerned because this seems, frankly, to be a waste of state resources and furthers the administration\u2019s anti-immigrant agenda,\u201d said Ben D\u2019Avanzo, senior health advocacy strategist with the National Immigration Law Center, an advocacy group. \u201cThis duplicates what states already do,\u201d he said.\n <\/p>\n \n As part of the administration\u2019s crackdown on people in the U.S. without authorization, President Donald Trump in February directed federal agencies to take action to ensure they are not obtaining benefits in violation of federal law.\n <\/p>\n \n In June, advisers to Health and Human Services Secretary Robert F. Kennedy Jr. ordered CMS to share information about Medicaid enrollees with the Department of Homeland Security, drawing a lawsuit by some states alarmed that the administration would use the information for its deportation campaign against unauthorized residents.\n <\/p>\n